Depression in Children and Adolescents

Jasmine was seventeen and in her third year of secondary school when her favourite aunt died suddenly. Her parents both worked, and she was often alone in the evenings, so she had been in the habit of visiting her aunt on her way home from school each day. They would have long talks about work and life and friends. In fact, her aunt was her best friend.

Jasmine was tall for her age, and very pretty. In year 8 a girl in her class who was much shorter and not as pretty had begun to make fun of her. She and her friends had teased Jasmine cruelly in the halls and after school, to the point where she had been reluctant to go to school. In year 10 she had finally told her school guidance counsellor. The girl and her friends had been warned to stay away from her but, as a result, many of her classmates had avoided her as well. Jasmine told her family doctor that she was sleeping poorly and that her school marks had dropped. She was desperately lonely since her aunt’s death. She felt helpless to change things in her life, and felt life was no longer worth living. Jasmine’s doctor placed her on an anti­depressant. Slowly she began to sleep better and became less tearful. She shared her feelings and ideas with her doctor, and gradually began to feel she could try to meet new friends.

All of us hope our children will be healthy and happy. We feel wonderful when they are secure and sociable, enjoying friends and activities and being curious to learn. Unfortunately, we aren’t always able to protect them from upsetting experiences and feelings. Sometimes, all we can do is deal with the setbacks when they happen.

Depression in children seems to be on the increase. Between the ages of nine and seventeen at least 21 per cent of children show some emotional problems, and about 11 per cent have significantly impaired functioning at home, at school, and with their friends. The good news is that the disorder responds to treatment.

Sometimes depression in children appears similar to the adult illness, but more often your child’s level of develop­ment determines how it looks. You may have trouble deciding whether your child needs treatment or is just going through a developmental stage that will pass. If your three-year-old has a temper tantrum, you expect it. If your eight-year-old behaves the same way, you start to worry.

Ahmed was three-and-a-half when his mother was killed in a car accident. His parents had divorced and his father had remarried and lived at the other end of the country. He and his new wife took custody of Ahmed, although previously they had seen him for only brief periods. At first Ahmed seemed contented enough, but within a week or two he started to have nightmares and would call out in his sleep. He would sob for long periods during the night, but would arch his back and pull away if his father or stepmother tried to comfort him. He seemed inconsolable. Both parents were aware that the loss of his mother was overwhelming for him, but eventually they became exhausted by his whining and demanding Behavior. Nothing seemed to make him happy. He began wetting his pants, and sometimes even messing his pants, although he had been completely toilet trained. His stepmother had not had children, and was looking forward to having her own. His father felt they had to put any plans to have children on hold because Ahmed’s needs were paramount. This tension between the parents only made matters worse.

Ahmed was finally assessed at the local child guidance clinic. The parents were interviewed with him, to discuss their frustrations and sense of helplessness. Up to this time, no one had talked to Ahmed about his mother, for fear of upsetting him further. The animosity between Ahmed’s natural parents had made it hard for his father to be neutral when discussing his ex-wife, while she had kept the boy from visiting his father and getting to know him. Finally, with the counsellor’s help, the couple was able to accept Ahmed’s need to grieve for his mother, and to make him feel welcome and safe in his new home. The symptoms decreased, but it was a long time before they disappeared.